Inter-personal Brain Coupling Between Preterm Infants, Their Parents and a Musician During Creative Music Therapy Using Functional Near-infrared Imaging (fNIRI) Hyperscanning

Background Preterm infants represent a growing population in health care. Unfortunately, many infants suffer from neurodevelopmental impairments that persist into adolescence and adulthood. Besides other risk factors, auditory deprivation (e.g., the lack of exposure to regular intrauterine rhythms of the maternal heartbeat and the maternal voice), and the overwhelming stressful auditory environment of an intensive care unit may negatively impact brain maturation. Studies showed that infant-parent separation can impede the bidirectional development of physical, emotional, and psychological bonds between parents and their infants. Brain development is linked to nurturing social contact and early auditory experience, as demonstrated by human and animal studies. New studies showed, music is promoting neurobiological processes and neuronal learning in the human brain, which starts before birth.

Rationale Creative Music Therapy (CMT) provides meaningful interactions and a nurturing enrichment of the auditory environment by infant-directed singing in lullaby-style. Positive short-term music therapy outcomes (i.e., arousal, behavior, respiratory rate, maternal anxiety) have been shown in several reviews. Preliminary results of a recent pilot feasibility randomized controlled trial (RCT) suggest that functional brain connectivity as measured by resting-state functional magnet resonance imaging seems to have a possible early beneficial effect of CMT which manifests in (1) lower thalamo-cortical processing delay, (2) stronger functional networks, and (3) higher functional integration in predominantly left prefrontal, supplementary motor and inferior temporal brain regions. Depressive symptoms may be decreased and physical connectedness increased between infants and their parents with CMT. However, real time evaluation of CMT's possible immediate effect on the brain activity in infants and inter-personal synchronization processes between parents and infants have not been conducted yet.

The primary objective is to explore if CMT:

Improves inter-personal interaction between the infant, the parent (i.e. the mother or father) and the music therapist assessed via cerebral oxygenation synchronization between the infant and parent as well as the infant and the music therapist in the left auditory cortex and frontal cortex.

The secondary objectives are to explore if CMT: